2013-05-13T16:47:08-05:00 2012-06-30 860683059 BEACHFLEISCHMAN PC PO BOX 64130 TUCSON AZ 857284130 990 2011-07-01 860492210 UNIVERSITY MEDICAL CENTER CORPORATION UNIV 5206942700 1501 N CAMPBELL AVENUE TUCSON AZ 85724 MISTY D HANSEN 5206942700 2013-05-09 1 KELLY L MELTZER CPA P00633511 5203214600 2011 2016-02-24 21:20:13Z THE UNIVERSITY OF ARIZONA MEDICAL CENTER CORPORATION MICHAEL R WALDRUM MD 1501 N CAMPBELL AVENUE TUCSON AZ 85724 893229092 0 X WWW.UAHEALTH.COM X 1984 AZ ADVANCING HEALTH AND WELLNESS THROUGH EDUCATION, RESEARCH, AND PATIENT CARE. 6 4 3712 954 761928 185239 10547083 16984623 602207108 627965985 4465640 -558187 189049 160474 617408880 644552895 24943132 19382429 0 0 256459200 249297974 0 0 66979 315797463 371160871 597199795 639841274 20209085 4711621 598726338 650129553 361542044 409838549 237184294 240291004 X ADVANCING HEALTH AND WELLNESS THROUGH EDUCATION, RESEARCH, AND PATIENT CARE. 0 0 579246104 19382249 627345842 THE UNIVERSITY OF ARIZONA MEDICAL CENTER IS COMMITTED TO DELIVERING LEADING-EDGE PATIENT CARE TO PATIENTS AND THEIR FAMILIES IN A SUPPORTIVE AND CARING ENVIRONMENT. WE OFFER A BROAD RANGE OF INPATIENT AND OUTPATIENT SERVICES, INCLUDING ONCOLOGY, CARDIOVASCULAR SERVICES, PEDIATRIC SERVICES, TRANSPLANT PROGRAMS, AND TRAUMA AND EMERGENCY SERVICES. OPERATING AS THE SOLE LEVEL 1 TRAUMA CENTER IN SOUTHERN ARIZONA SINCE 2003, EMERGENCY MEDICINE PROVIDES TRAUMA CARE TO ALL OF SOUTHERN ARIZONA. THE UNIVERSITY OF ARIZONA MEDICAL CENTER'S ONCOLOGY PROGRAM OFFERS A MULTI-DISCIPLINARY CARE TO PATIENTS ACROSS ARIZONA, EXCELLING IN GROUND-BREAKING RESEARCH, EDUCATION, AND OUTREACH PROGRAMS. OUR FACILITIES INCLUDE AN OUTPATIENT CLINICAL FACILITY; A "ONE STOP" CENTER WHERE PATIENTS RECEIVE A VARIETY OF SUPPORT SERVICES AS WELL AS LEADING-EDGE CANCER THERAPIES. IN 2010, THE UNIVERSITY OF ARIZONA MEDICAL CENTER OPENED THE DIAMOND CHILDREN'S MEDICAL CENTER, A FACILITY DESIGNED TO PROVIDE THE MOST ADVANCED PEDIATRIC HEALTH CARE POSSIBLE WHILE MAINTAINING A COMFORTABLE, HEALING, ATMOSPHERE FOR CHILDREN AND THEIR FAMILIES. 579246104 1 1 0 1 0 0 0 1 0 1 1 0 0 1 1 0 0 1 0 1 1 0 0 0 0 0 1 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 305 0 1 3712 1 1 1 1 CJ 0 0 0 0 0 0 0 0 X 6 4 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 AZ X DONELLA FONES 5206942700 1501 N CAMPBELL AVENUE TUCSON AZ 85724 LINDA MAZON GUTIERREZ 1.00 X 0 0 0 DAVID LABINER MD 1.00 X 0 347220 87996 BARBARA PECK 1.00 X 0 0 0 JODI MANSFIELD 40.00 X X 0 257830 0 KEVIN J BURNS 40.00 X X 1880456 0 26542 HENRY E WELLS 40.00 X X 0 245171 0 KAREN MLAWSKY 40.00 X X 653041 0 72640 LEO J BRENNAN 1.00 X X 0 0 0 EDMUND L JENKINS 1.00 X X 0 0 0 MISTY D HANSEN 40.00 X 595126 0 91107 JUDY A DYE 40.00 X 361725 0 31322 VICTORIA D BEGAN 40.00 X 261273 0 68220 MARTHA G ENRIQUEZ 40.00 X 489471 0 7174 MARIA A KLEMMEDSON 40.00 X 577484 0 32120 KENT D ROLLINS 40.00 X 390800 0 27050 SAMIR Y DAHDAL 40.00 X 419410 0 20923 MICHAEL J DARRAGH 40.00 X 336626 0 31838 ERIC A BRODY 40.00 X 375401 0 19265 ROBERT B DZIOBA 40.00 X 419950 0 24169 6760763 850221 540366 229 0 1 0 UNIVERSITY OF ARIZONA 888 N EUCLID TUCSON AZ 85719 HEALTH CARE PROFESSIONALS 29966987 THE UNIVERSITY OF ARIZONA PHYSICIANS 1501 N CAMPBELL AVE TUCSON AZ 85724 HEALTH CARE PROFESSIONALS 15917384 ARAMARK CORPORATION PO BOX 651009 CHARLOTTE NC 28265 FOOD SERVICE 10170656 AMERICAN RED CROSS 222 S CHERRY AVENUE TUCSON AZ 85719 BLOOD PROCESSING SERVICES 7307021 DONOR NETWORK OF ARIZONA 3877 N 7TH STREET SUITE 200 PHOENIX AZ 85014 MEDICAL SERVICES 4863638 39 521345 16463278 521345 16984623 NET PATIENT REVENUE 621500 606998990 606378847 620143 OTHER OPERATING INCOME 812930 10731810 10731810 TEACHING SERVICES 611600 8587009 8587009 SERVICES TO OTHER ORGA 722320 1648176 1648176 627965985 2658685 2658685 961618 961618 32419 13730 18689 18689 18689 244483977 248662467 -4178490 -4178490 -4178490 PARKING REVENUE 812930 141785 141785 141785 644552895 627345842 761928 -539498 19337717 19337717 44712 44712 7213133 7213133 208115185 208115185 11866589 11866589 6619021 6619021 15484046 15484046 249276 249276 129219990 87139375 42080615 2804921 55198 2728371 21352 5105150 1025481 4039611 40058 3365396 246006 3116170 3220 7948482 7948482 476126 163270 312856 445404 398232 47172 16871199 16871199 29804406 24112114 5692292 8225980 8225980 SUPPLIES 144701492 143828303 873174 15 EQUIPMENT MAINTENANCE 12874712 12874712 OTHER 8088825 7677349 409142 2334 TAXES ON UBTI 979512 979512 639841274 579246104 60528191 66979 4138172 32494505 87992348 91829946 277 0 11973313 13909120 8280330 52405679 631969003 319407235 320597866 312561768 121280038 80986844 112128 567958 393202 43896036 65436361 598726338 650129553 57626747 48328283 463987 199260 275705541 312497150 1112878 657459 26632891 48156397 361542044 409838549 X 0 0 0 0 237184294 240291004 237184294 240291004 598726338 650129553 X 4711621 -1604911 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 0 0 0 307673 0 307673 640447870 762922132 640447870 763229805 1000000 1000000 250000 250000 0 0 0 0 1000000 1000000 1000000 1000000 4000000 6000000 72887 117887 238409 307673 736856 250000 250000 250000 250000 1000000 1500000 299815 X 0 1135932 1135932 1334053 195923 394044 1135932 1331702 24506 -22155 1334053 362534 919177 49991 1331702 1.00000 0 1 1 11521199 11521199 405831157 154177238 251653919 8673657 2437398 6236259 205942990 162792599 43150391 312561768 ASSETS HELD BY TRUSTEE 35952034 ART 299815 DUE FROM THE UNIVERSITY OF ARIZONA HEALTH NETWORK 21349509 OTHER ASSETS 7309073 DUE FROM UNIVERSITY OF ARIZONA PHYSICIANS 511311 DUE FROM UNIVERSITY MEDICAL CENTER FOUNDATION 14619 65436361 DUE TO THIRD PARTY 6445160 OTHER LIABILITIES 15802849 DUE TO UNIVERSITY OF ARIZONA PHYSICIANS 16208358 INTEREST PAYABLE 8429825 DUE TO UNIVERSITY MEDICAL CENTER FOUNDATION 1270205 48156397 PART III, LINE 4: UNIVERSITY MEDICAL CENTER CORPORATION'S ART COLLECTION PROMOTES AN ATMOSPHERE OF HEALING FOR PATIENTS AND THEIR LOVED ONES. DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: UNIVERSITY MEDICAL CENTER FOUNDATION'S ENDOWMENT FUNDS ARE PROGRAM SUPPORT FOR VARIOUS DEPARTMENTS AT THE UNIVERSITY OF ARIZONA MEDICAL CENTER. CENTRAL AMERICA AND THE CARRIBEAN 0 1 PROGRAM SERVICE CAPTIVE INSURANCE 18068000 0 1 0 0 0 1 18068000 0 18068000 1 0 1 0 1 0 METHOD USED TO ACCCOUNT FOR EXPENDITURES: SCHEDULE F, PART I, LINE 3: AMOUNT SHOWN REFLECTS TOTAL ASSETS OF UMCC INSURANCE FUNDING LIMITED, AN OFFSHORE CAPTIVE INSURANCE COMPANY. 1 1 X 1 X 1 X 1 1 1 0 0 35243093 12702039 22541054 0.03520 145000942 141198628 3802314 0.00590 180244035 153900667 26343368 0.04110 262116 262116 0.00040 30600954 15097051 15503903 0.02420 20679156 17508118 3171038 0.00500 53410 75 53335 0.00010 19382249 19382249 0.03030 70977885 32605244 38372641 0.06000 251221920 186505911 64716009 0.10110 98294 98294 0.00020 444867 444867 0.00070 543161 543161 0.00090 0 24743807 0 117178088 117295504 -117416 X 1 1 1 UM LEASING LLC LEASING 0.50000 0.00000 0.00000 1 1 UAMC-UNIVERSITY CAMPUS

1501 N CAMPBELL AVENUE TUCSON AZ 85724

X X X X X X UAMC-UNIVERSITY CAMPUS 1 1 1 100.000000000000 1 200.000000000000 1 X X X X X X 1 1 X X X X 1 0 1 X X 0 0 12 UAMC-HOME HEALTH SERVICE

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HOME HEALTH/INFUSION UAMC-ALVERNON CLINIC

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OUTPATIENT PHYSICIAN CLINIC DIAGNOSTIC TESTING UAMC-NORTH CAMPUS

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ONCOLOGY SERVICES UAMC-GREEN VALLEY PHYSICIAN CLINIC

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OUTPATIENT PHYSICIAN CLINIC UAMC-ORANGE GROVE CAMPUS

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OUTPATIENT PHYSICIAN CLINIC UAMC-PANTANO CLINIC

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OUTPATIENT PHYSICIAN CLINIC UAMC-IMAGING CENTER

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DIAGNOSTIC CENTER UAMC-PHOENIX TRANSPLANT CLINIC

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DIAGNOSTIC TESTING UAMC-UNIVERSITY CAMPUS SURGERY

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OUTPATIENT PHYSICIAN CLINIC UAMC-ALVERNON SURGERY CENTER

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OUTPATIENT PHYSICIAN CLINIC UAMC-LA CHOLLA PHYSICIANS

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OUTPATIENT PHYSICIAN CLINIC PART I, LINE 7: THE ESTIMATED NET COSTS, IN EXCESS OF REIMBURSEMENT, IS DETERMINED USING A COST ACCOUNTING SYSTEM, WHICH ADDRESSES ALL PATIENT SEGMENTS INCLUDING MEDICAID, MEDICARE, UNINSURED OR SELF-PAY. PART II: THE UNIVERSITY OF ARIZONA MEDICAL CENTER IS COMMITTED TO THE COMMUNITY IT SERVES AS WELL AS THE PROMOTION OF PUBLIC HEALTH. THE UNIVERSITY OF ARIZONA MEDICAL CENTER SUPPORTS MANY LOCAL CHARITABLE ORGANIZATIONS, INCLUDING TUCSON FESTIVAL OF BOOKS, AMERICAN HEART ASSOCIATION, AMERICAN CANCER SOCIETY, JUVENILE DIABETES RESEARCH FOUNDATION AND OTHERS NOT ONLY WITH FINANCIAL CONTRIBUTIONS BUT WITH HOSPITAL VOLUNTEERS AS WELL. IN NOVEMBER OF 2011 THE ORGANIZATION SPONSORED THE 29TH ANNUAL EL TOUR DE TUCSON, A 109 MILE BIKE RIDE AND IMPORTANT TUCSON COMMUNITY EVENT PROMOTING HEALTH AND WELLNESS. IN ADDITION, THE UNIVERSITY OF ARIZONA MEDICAL CENTER PARTICIPATES IN A VARIETY OF HEALTH FAIRS, PROVIDING FREE SCREENINGS, SUCH AS BLOOD PRESSURE CHECKS, AS WELL AS CPR INSTRUCTION. PART III, LINE 4: FINANCIAL STATEMENT FOOTNOTE FOR PATIENT ACCOUNTS RECEIVABLE: "PATIENT ACCOUNTS RECEIVABLE ARE REPORTED NET OF ESTIMATED ALLOWANCES FOR CONTRACTUAL ADJUSTMENTS AND ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS. ESTIMATED ALLOWANCES FOR CONTRACTUAL ADJUSTMENTS AND UNCOLLECTIBLE ACCOUNTS ARE APPROXIMATELY $266,988,000 AND $211,907,000 AS OF JUNE 30, 2012 AND 2011, RESPECTIVELY."BAD DEBT EXPENSE IS REPORTED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES AND IS NOT INCLUDED AS PART OF COMMUNITY BENEFIT. FINANCIAL COUNSELORS ASSIST PATIENTS WITH CHARITY CARE APPLICATIONS AND UNINSURED DISCOUNT PROGRAM AND IDENTIFY IF PATIENTS ARE ELIGIBLE FOR THESE PROGRAMS. PART III, LINE 8: THE MEDICARE ALLOWABLE COSTS OF CARE IS REPORTED FROM THE UNIVERSITY OF ARIZONA MEDICAL CENTER'S MEDICARE COST REPORT. PART III, LINE 9B: IF SUBSEQUENT EVENTS REVEAL FINANCIAL HARDSHIP, PATIENTS MAY APPLY FOR CHARITY CARE AND RECEIVE DISCOUNTS BASED ON THEIR FINANCIAL CIRCUMSTANCES. UAMC-UNIVERSITY CAMPUS PART V, SECTION B, LINE 19D: FOR HOSPITAL SERVICES THAT DO NOT HAVE MEDICARE RATES, PATIENTS PAY 35% OF FULL BILLED CHARGES. PART VI, LINE 2: IN THE FALL OF 2011, THE THREE MAJOR NON-PROFIT HEALTH SYSTEMS IN PIMA COUNTY - CARONDELET HEALTH NETWORK, TUCSON MEDICAL CENTER, AND THE UNIVERSITY OF ARIZONA MEDICAL CENTER - COMBINED EFFORTS TO CONDUCT A COUNTY-WIDE COMMUNITY HEALTH NEEDS ASSESSMENT. THIS COLLABORATION ALLOWED FOR HEALTH SYSTEMS TO WORK CLOSELY WITH ONE ANOTHER, BRING TOGETHER KEY MEMBERS OF THE COMMUNITY, AND SHARE RESOURCES TO COMPLETE THE ASSESSMENT AND BETTER UNDERSTAND THE HEALTH SERVICES SECTOR IN THE REGION. PART VI, LINE 3: THE UNIVERSITY OF ARIZONA MEDICAL CENTER PROVIDES HEALTH CARE SERVICES FREE OR AT A REDUCED CHARGE TO INDIVIDUALS WHO MEET CERTAIN FINANCIAL CRITERIA. ALL PATIENTS IN NEED OF EMERGENCY SERVICES ARE ACCEPTED REGARDLESS OF THEIR ABILITY TO PAY. WE ALSO OFFER SUBSTANTIAL DISCOUNTS TO INDIVIDUALS WHO LACK INSURANCE OR WHOSE INSURANCE COVERAGE MAY NOT COVER CERTAIN SERVICES UNDER ITS POLICY FOR THE UNINSURED AND UNDERINSURED. UNDER THIS PROGRAM, PATIENTS ARE CHARGED NO MORE THAN THE RATE THE CORPORATION RECEIVED UNDER THE MEDICARE PROGRAM. IN ADDITION, FINANCIAL COUNSELORS ASSIST PATIENTS WITH THE ORGANIZATION'S CHARITY CARE APPLICATION AS WELL AS APPLYING FOR OTHER FEDERAL, STATE, AND LOCAL MEDICAL ASSISTANCE PROGRAMS FOR WHICH THEY MAY BE ELIGIBLE. PART VI, LINE 4: THE UNIVERSITY OF ARIZONA MEDICAL CENTER PROVIDES QUATERNARY HEALTHCARE AND IS A MAJOR REFERRAL CENTER FOR THE STATE AND OTHER SOUTHWESTERN STATES. THE HOSPITAL IS ONE OF EIGHT NON-FEDERAL ACUTE CARE HOSPITALS IN METROPOLITAN TUCSON, WHICH CONSISTS OF THE CITY OF TUCSON AND IMMEDIATELY SURROUNDING AREAS (HEREINAFTER REFERRED TO AS "METROPOLITAN TUCSON"). THE CITY OF TUCSON IS THE SECOND LARGEST CITY IN ARIZONA AND THE ONLY METROPOLITAN AREA IN PIMA COUNTY, ARIZONA. PIMA COUNTY COVERS 9,184 SQUARE MILES, INCLUDING DIVERSE CHANGES IN ELEVATION, TOPOGRAPHY, AND CLIMATE. SEVERAL NATIVE AMERICAN TRIBAL NATIONS HAVE RESERVATION LANDS IN THE COUNTY WHICH TOGETHER TOTAL 42.1% OF PIMA COUNTY LAND. ACCORDING TO 2007 POPULATION PROJECTIONS BY THE CITY OF TUCSON DEPARTMENT OF URBAN PLANNING & DESIGN, IT IS ESTIMATED THAT THE PIMA COUNTY AREA HAS APPROXIMATELY 1,000,000 RESIDENTS IN 2008 AND WILL EXCEED 1,100,100 BY 2012. TUCSON IS LOCATED APPROXIMATELY 60 MILES NORTH OF THE U.S. - MEXICO BORDER. PIMA COUNTY, WHICH ACCOUNTS FOR APPROXIMATELY 15% OF THE STATE'S POPULATION HAS A CROSS SECTION OF EMPLOYERS WITH HEAVY EMPHASIS IN SERVICES, TRADE, GOVERNMENT, MILITARY, MINING, AND MANUFACTURING. METROPOLITAN TUCSON ACCOUNTS FOR APPROXIMATELY 54% OF THE POPULATION IN PIMA COUNTY. PART VI, LINE 5: THE UNIVERSITY OF ARIZONA MEDICAL CENTER IS THE ONLY LEVEL ONE TRAUMA CENTER IN SOUTHERN ARIZONA AND AS SUCH TAKE A LEADERSHIP ROLE IN IMPROVING SYSTEMS OF CARE FOR TRAUMA PATIENTS. TRAUMA EDUCATION, INJURY PREVENTION, AND DISASTER PREPAREDNESS EFFORTS IN THE REGION ARE OFTEN LED BY STAFF AT THE UNIVERSITY OF ARIZONA MEDICAL CENTER, WHO HAVE SPENT HUNDREDS OF HOURS PROVIDING PROFESSIONAL AND COMMUNITY WIDE EDUCATION.CONSISTENT WITH ITS NONPROFIT STATUS, THE UNIVERSITY OF ARIZONA MEDICAL CENTER USES SURPLUS REVENUES TO REINVEST IN FACILITIES, TECHNOLOGY, AND MEDICAL SERVICES FOR THE COMMUNITY. PART VI, LINE 6: THE UNIVERSITY OF ARIZONA HEALTH NETWORK (UAHN) IS ARIZONA'S FIRST ACADEMIC MEDICAL NETWORK. IT INCLUDES THE UNIVERSITY OF ARIZONA MEDICAL CENTER - UNIVERSITY CAMPUS, THE UNIVERSITY OF ARIZONA MEDICAL CENTER - DIAMOND CHILDREN'S, THE UNIVERSITY OF ARIZONA MEDICAL CENTER - SOUTH CAMPUS, SOME 40 CLINICS, A HEALTH PLAN DIVISION AND THE PRACTICE PLAN FOR PHYSICIANS FROM THE UNIVERSITY OF ARIZONA COLLEGE OF MEDICINE. IT'S BEEN NATIONALLY RECOGNIZED FOR PROVIDING EXCEPTIONAL PATIENT CARE, TEACHING NEW HEALTH CARE PROFESSIONALS AND CONDUCTING GROUNDBREAKING RESEARCH THROUGH THE PHYSICIAN-SCIENTISTS OF THE UNIVERSITY OF ARIZONA COLLEGE OF MEDICINE. UAHN, WHICH WORKS IN PARTNERSHIP WITH THE UNIVERSITY OF ARIZONA COLLEGE OF MEDICINE, WAS CREATED TO FACILITATE BETTER COORDINATION, INTEGRATION AND PROMOTION OF CLINICAL ACTIVITIES TO SUPPORT THE COLLEGE OF MEDICINE'S EDUCATION, RESEARCH AND PATIENT-CARE GOALS. THE UNIVERSITY OF ARIZONA MEDICAL CENTER - UNIVERSITY CAMPUS OPENED IN 1971 AND IS THE PRIMARY TEACHING HOSPITAL OF THE UNIVERSITY OF ARIZONA COLLEGES OF MEDICINE, NURSING AND PHARMACY. 1 PERIMETER CYCLING 2609 E BROADWAY TUCSON AZ 85716 860830696 501(C)(3) 119420 TO PROMOTE AWARENESS OF HEALTH BENEFITS OF CYCLING TO GENERAL PUBLIC THE UNIVERSITY OF ARIZONA PHYSICIANS 1501 N CAMPBELL AVENUE TUCSON AZ 85724 942958258 501(C)(3) 9085680 MISSION SUPPORT THE UNIVERSITY OF ARIZONA COLLEGE OF MEDICINE 888 N EUCLID TUCSON AZ 85719 742652689 STATE OF ARIZONA 7808523 MISSION SUPPORT FOR THE UNIVERSITY OF ARIZONA COLLEGE OF MEDICINE UNIVERSITY MEDICAL CENTER FOUNDATION 1501 N CAMPBELL AVENUE TUCSON AZ 85724 860572438 501(C)(3) 2220986 SOLICIT AND ADMINISTER SUPPORT FOR THE UNIVERSITY OF ARIZONA MEDICAL CENTER 4 NON-CASH 1074 44712 FMV PRESCRIPTION DRUGS FROM OUTPATIENT PHARMACY, RENT PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE MISSION OF THE UNIVERSITY OF ARIZONA MEDICAL CENTER INCLUDES SUPPORT OF LOCAL COMMUNITIES BY PARTICIPATING IN AND SPONSORING CHARITABLE AND SERVICE ORGANIZATIONS. OUR GRANT AND SPONSORSHIP COMMITTEE MEETS MONTHLY TO REVIEW GRANT REQUESTS AND DETERMINES THE HIGHEST AND BEST USE OF OUR GRANT FUNDS WITHIN OUR SERVICE AREAS AND LOCAL COMMUNITIES. THE UNIVERSITY OF ARIZONA MEDICAL CENTER PROMOTES INVESTING IN OUR COMMUNITY IN MULTIPLE WAYS, INCLUDING FINANCIAL CONTRIBUTIONS THROUGH GRANTS AND INVOLVING OUR EMPLOYEES IN SERVICE PROGRAMS AND ACTIVITIES. X X X X X X 1 1 0 0 0 0 0 0 0 DAVID LABINER MD 0 265394 0 70441 0 11385 0 69877 0 18119 0 435216 0 0 JODI MANSFIELD 0 257830 0 0 0 0 0 0 0 0 0 257830 0 0 KEVIN J BURNS 310302 0 286209 0 1283945 0 19487 0 7055 0 1906998 0 0 0 HENRY E WELLS 0 245171 0 0 0 0 0 0 0 0 0 245171 0 0 KAREN MLAWSKY 388670 0 261448 0 2923 0 63095 0 9545 0 725681 0 0 0 MISTY D HANSEN 395981 0 196796 0 2349 0 75461 0 15646 0 686233 0 0 0 JUDY A DYE 210708 0 146204 0 4813 0 25533 0 5789 0 393047 0 0 0 VICTORIA D BEGAN 168366 0 91057 0 1850 0 56250 0 11970 0 329493 0 0 0 MARTHA G ENRIQUEZ 48512 0 10365 0 430594 0 6418 0 756 0 496645 0 92248 0 MARIA A KLEMMEDSON 107159 0 177044 0 293281 0 29292 0 2828 0 609604 0 0 0 KENT D ROLLINS 222008 0 151307 0 17485 0 25546 0 1504 0 417850 0 0 0 SAMIR Y DAHDAL 391456 0 27580 0 374 0 19487 0 1436 0 440333 0 0 0 MICHAEL J DARRAGH 269652 0 66066 0 908 0 19487 0 12351 0 368464 0 0 0 ERIC A BRODY 372904 0 1698 0 799 0 6677 0 12588 0 394666 0 0 0 ROBERT B DZIOBA 415866 0 0 0 4084 0 19487 0 4682 0 444119 0 0 0 PART I, LINES 4A-B THE FOLLOWING PEOPLE RECEIVED SEVERANCE PAYMENTS: KEVIN J. BURNS $1,281,641, MARTHA G. ENRIQUEZ $338,270, MARIA A. KLEMMEDSON $290,726. THE FOLLOWING PEOPLE PARTICIPATED IN AND/OR RECEIVED PAYMENTS FROM A NON-QUALIFIED RETIREMENT PLAN: KEVIN J. BURNS $286,209, MISTY D. HANSEN $52,050, MARIA A. KLEMMEDSON $175,793, MARTHA G. ENRIQUEZ $102,613, JUDY A. DYE $34,383, VICTORIA D. BEGAN $31,955, KAREN MLAWSKY $128,041, KENT D. ROLLINS $43,523. UNIVERSITY MEDICAL CENTER CORPORATION 860492210 914446AVI 2005-11-10 139802720 FINANCE CONSTRUCTION 0 0 0 UNIVERSITY MEDICAL CENTER CORPORATION 860492210 914446AS8 2004-03-03 53188604 FINANCE CONSTRUCTION 0 0 0 UNIVERSITY MEDICAL CENTER CORPORATION 860492210 914446BF5 2009-05-28 60172570 FINANCE CONSTRUCTION 0 0 0 UNIVERSITY MEDICAL CENTER CORPORATION 860492210 914062DK7 2011-08-09 74228012 FINANCE CONSTRUCTION & REFUND PRIOR ISSUE 0 0 0 495000 139802720 11085750 1036763 127680207 2010 0 0 1 1 12080000 53188604 4294750 20992549 716470 27184835 2007 1 1 1 1 60172570 4187277 868287 55117006 2010 0 0 1 1 74228012 2427675 32679599 963609 38157130 2011 1 0 1 1 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 BAYERISCHE LANDESBANK 3.000000000000 0 0 0 0 0 0 0 0 0 X 1834 FAIR MARKET VALUE X 128326 FAIR MARKET VALUE X 34 391185 FAIR MARKET VALUE 1 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE UNIVERSITY OF ARIZONA HEALTH NETWORK IS THE SOLE MEMBER OF THE UNIVERSITY OF ARIZONA MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 7A THE UNIVERSITY OF ARIZONA HEALTH NETWORK, AS THE SOLE MEMBER OF THE UNIVERSITY OF ARIZONA MEDICAL CENTER, ELECTS THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE UNIVERSITY OF ARIZONA HEALTH NETWORK, AS THE SOLE MEMBER OF THE UNIVERSITY OF ARIZONA MEDICAL CENTER, APPROVES AND/OR RATIFIES SIGNIFICANT DECISIONS MADE BY THE UNIVERSITY OF ARIZONA MEDICAL CENTER GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE UNIVERSITY OF ARIZONA MEDICAL CENTER'S FORM 990 IS REVIEWED BY THE CHIEF FINANCIAL OFFICER, CHIEF EXECUTIVE OFFICER, AND AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS. THE FORM 990 IS DISTRIBUTED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE UNIVERSITY OF ARIZONA MEDICAL CENTER BOARD OF DIRECTORS HAS ADOPTED WRITTEN CONFLICT OF INTEREST POLICIES WHICH ESTABLISH PROCEDURES FOR THE IDENTIFICATION AND DISCLOSURE OF CONFLICTS OF INTEREST. UNDER THESE POLICIES, CONFLICTED DIRECTORS, OFFICERS AND EMPLOYEES ARE TO REFRAIN FROM PARTICIPATING IN ANY DECISION OR ACTION BY UAMC INVOLVING THE CONFLICT. DIRECTORS AND MEMBERS OF SENIOR MANAGEMENT OF UAMC ARE REQUIRED ANNUALLY TO REVIEW UAMC'S CONFLICT OF INTEREST POLICY AND COMPLETE AND SIGN A CONFLICT OF INTEREST QUESTIONNAIRE. FORM 990, PART VI, SECTION B, LINE 15 THE UNIVERSITY OF ARIZONA MEDICAL CENTER HIRES A THIRD PARTY CONSULTANT TO REVIEW COMPENSATION AND BENEFITS. IN ADDITION, THE UNIVERSITY OF ARIZONA MEDICAL CENTER COMPLETES A SURVEY COMPARING THE COMPENSATION PACKAGES TO SIMILAR ORGANIZATIONS. THE CHIEF EXECUTIVE OFFICER HAS A WRITTEN EMPLOYMENT CONTRACT THAT IS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE AND BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 POLICIES ARE POSTED ON THE UNIVERSITY OF ARIZONA MEDICAL CENTER'S INTRANET. GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -1,604,911. 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